What is a surgical abortion?

Surgical abortion—also commonly known as suction or vacuum aspiration—is a method that uses a vacuum aspiration machine to cleanse out the uterus, including the fetus. Surgical abortion is the most common method of first trimester abortions performed. Another option for abortion during the first trimester is a medically-induced abortion. Any abortion after the first trimester is a late term abortion. Surgical abortions are generally performed up to 14 weeks of gestation (or 14 weeks after the first day of the last menstrual period This surgery is performed on an outpatient basis in a doctor’s office and usually requires only local anesthetic and oral pain-relievers in addition.1

Procedure:

First, a physician determines the location and size of the uterus by performing a pelvic exam or an ultrasound, then the patient is given pain medication. If the abortion is taking place on a person less than 12 weeks pregnant, they will be given medications such as Vicodin or Ibuprofen. If between 12-14 weeks pregnant, misoprostol will also be provided in order to soften the cervix to make the procedure easier and less painful.1

After the pain medications start their effects, the doctor follows these steps1:

The doctor inserts a speculum into the vagina to visualize the cervix.

The vaginal area is cleaned.

Numbing cream is applied to the cervix in order to reduce any pain.

The cervix is dilated in order to allow access to the uterus.

A thin flexible tube called a vacurette, the tool attached to the vacuum aspiration, is inserted through the cervix.

The vacurette applies gentle suction to clean out the uterine contents and pregnancy tissue.

The physician will carefully check the uterus with a eurette(a spoon-shaped instrument) to make sure all the contents are removed.

The suction portion usually takes around one minute, and the entire procedure takes about 10 to 20 minutes to complete.

Recovery:

After the abortion procedure is finished, it is recommended to rest for a few minutes. Patients are encouraged to wait in the recovery room and will receive after-care instructions and an emergency care phone number.

The doctor may prescribe antibiotics, pain medications, or birth control if requested.1 Patients should arrange transportation in advance, and should go home to rest and recover. Most patients are able to return to their normal activities the next day. Unless there are serious complications, a follow-up visit is usually not required. A normal menstrual period can be expected 4 to 6 weeks following the abortion. It is recommended to abstain from sex for at least one week following the abortion, after which time intercourse can be continued. It is possible to become pregnant immediately after an abortion—even if the normal menstrual period hasn’t occurred—so it is important to use proper birth control methods when having sexual intercourse.

Side effects:

Some side effects to expect from the procedure include cramping that feels similar to menstrual cramps and light vaginal bleeding.2

Rare side effects and risks of the surgery include: blood clots in the uterus, heavy bleeding, injury to the cervix or other organs, allergic reactions to the medications, infection, incomplete abortion(part of the pregnancy is left inside of the uterus), undetected ectopic pregnancy, and failure to end the pregnancy.2 These risks are low and depend on the woman’s overall health and how far along the pregnancy is—if the surgery occurs later into the pregnancy, these risks are more common.

Other potentially serious complications may occur.2 A health care provider should be contacted immediately if the patient has:

Extremely heavy bleeding: if blood clots larger than a lemon pass

Severe pain that is not helped by medication or other means

Fever of over 100.4°F the day after the procedure

Nausea, vomiting, and/or diarrhea that lasts longer than 24 hours

Smelly discharge from the vagina

Signs of pregnancy

However, abortions are a safe procedure and these serious complications are not typical.